EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
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Review Comparative Study
Subclavian TAVI: more than an alternative access route.
The standard approach for transcatheter aortic valve implantation (TAVI) is through the transfemoral retrograde route, because it is minimally invasive and it is feasible under conscious sedation in a totally percutaneous fashion. When the transfemoral access is not feasible, the most used approaches are the transapical for the balloon-expandable Edwards SAPIEN XT valve, the subclavian for the Medtronic self-expandable CoreValve and the transaortic for both prostheses. ⋯ Although no direct comparison between the subclavian, transaortic and transapical approaches is available, in our opinion the subclavian access should be favoured, because of its lower invasiveness and its feasibility without general anaesthesia. The choice of vascular access should be taken by the Heart Team and should remain patient-centred rather than operator-preference driven.